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[在峡部裂型腰椎滑脱症手术治疗中使用椎间融合器进行腰骶椎前后路固定]

[Anterior and posterior stabilization of the lumbosacral spine with the usage of interbody cages in the operational treatment of the isthmic spondylolisthesis].

作者信息

Pankowski Rafał, Smoczyński Andrzej, Smoczyński Maciej, Luczkiewicz Piotr, Piotrowski Maciej

机构信息

Katedra i Klinika Ortopedii i Traumatologii Narzqdu Ruchu, Akademia Medyczna w Gdańsku.

出版信息

Chir Narzadow Ruchu Ortop Pol. 2006;71(1):15-20.

Abstract

In the following work results of the operational treatment of the isthmic spondylolisthesis by the posterior stabilization and anterior lumbosacral interbody fusion with the use of interbody implants--cages was taken under evaluation. The test group consisted of 21 patients (13 male and 8 male). The follow up period exceeded 2 years. The objective clinical outcome assessment was based on Oswestry disability questionnaire. Subjective clinical evaluation was done by the visual analog pain score and two questions concerning the evaluation of success of the operative treatment and a possible agreement to a following operation if necessary. The radiological results were done upon evaluation of the degree of the spondylolisthesis, the angle of the lumbosacral lordosis, the height of the interbody space and intervertebral foramen and the evaluation of the spinal fusion. The conclusion was that the usage of the distraction of the lumbosacral spine in the operational treatment of the isthmic spondylolisthesis result in the reduction of the slippage and the dynamic decompression of the compressed neural roots. The usage of the interbody cages prevented the loss of slippage correction, permanently reconstructed the anatomical conditions in the area of the operated spinal segment and helped to achieve good and very good clinical results in over 95% of patients. The fusion rate was 100%. The restoration of the correct height of the intervertebral foramen in the slip segment caused an improvement of the neurologic state. The usage of two level stabilization in the operative treatment of the isthmic spondylolisthesis prevented the initiation of the secondary degenerative changes adjacent to the fusion.

摘要

在以下研究中,对采用后路稳定术及前路腰骶椎间融合术并使用椎间融合器(cages)治疗峡部裂型腰椎滑脱的手术治疗结果进行了评估。试验组由21例患者组成(13例男性和8例女性)。随访期超过2年。客观临床结果评估基于Oswestry功能障碍问卷。主观临床评估通过视觉模拟疼痛评分以及两个关于手术治疗成功评估的问题和如有必要是否同意后续手术的问题来进行。放射学结果通过评估腰椎滑脱程度、腰骶前凸角度、椎间间隙和椎间孔高度以及脊柱融合情况得出。结论是,在峡部裂型腰椎滑脱的手术治疗中使用腰骶椎撑开可导致滑脱程度减轻以及受压神经根的动态减压。使用椎间融合器可防止滑脱矫正丢失,永久性重建手术节段区域的解剖条件,并有助于超过95%的患者取得良好及非常好的临床效果。融合率为100%。滑脱节段椎间孔正确高度的恢复改善了神经状态。在峡部裂型腰椎滑脱的手术治疗中使用双节段稳定可防止融合相邻节段继发退行性改变的发生。

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